Form

Parents Full Name:*

E-mail:*

Phone:*

Cell Phone*

Work Phone*

Address:*

City:*

State:*

Zip code:*

We use Passwords and School Codes to assist us in monitoring the requirements of each district. If you received a Password or School Code please enter it here- your account will reflect the requirements of your district at the time of shipment or pickup. Don't have a Password, or School Code? No Problem-it is not required to rent from us. Our customer service staff will assist you in receiving what your district requires.

Enter All Promo or School Codes- if any ( not required)

Instrument Requested*

School District*

School Attending*

Delivery Selection*

If an instructional method is indicated by your school, please list it here

I have a valid Drivers License (required)*

Yes

I have a valid credit card (required)***

Yes

When you you expect to pickup your instrument?

** Important Note: The rentor must present a valid drivers license, and a valid credit card issued to the rentor at the time of rental. The introductory rental and any other purchases will be charged to the credit card presented at the time of rental. Unfortunately we cannot make any exceptions to these requirements.

Thank you, we nomally will confirm your reservation within a few hours, but no later than the following business day if we receive your reservation when we are closed.